Average Medicaid Substance Abuse Treatment Payments
Typical Medicaid Substance Abuse Treatment reimbursement across 5,169 cities
Avg. Medicaid Paid
$58.84
Price Range
$0.00 – $10,105
Total Claims
490.4M
Cities
5169
Typical Payment Range
Typical Medicaid Substance Abuse Treatment payments fall between $34.14 and $105.27 per claim (median: $65.20). The top 10% of payments exceed $163.43.
Based on per-provider averages across all Medicaid claims in this category.
About This Procedure
Treatment programs for substance use disorders, including detoxification, counseling, medication-assisted treatment (MAT), and rehabilitation services.
Why do these costs look low?
These figures represent Medicaid reimbursement rates — the amounts that state Medicaid programs actually paid providers. Medicaid typically reimburses significantly less than private insurance or out-of-pocket prices. If you have private insurance or are paying cash, expect higher costs. See the cost components below for per-code averages.
Costs by City
| City | Avg. Paid | Min / Max | Claims | Providers |
|---|---|---|---|---|
| West Islip, NY | $40.02 | $40.02 – $40.02 | 12 | 1 |
| Boaz, AL | $0.00 | $0.00 – $0.00 | 12 | 1 |
| Fairport, NY | $33.00 | $33.00 – $33.00 | 12 | 1 |
| Centreville, VA | $243.00 | $243.00 – $243.00 | 12 | 1 |
| Chilton, WI | $35.35 | $35.35 – $35.35 | 12 | 1 |
| North Bergen, NJ | $0.00 | $0.00 – $0.00 | 12 | 1 |
| Lecanto, FL | $14.44 | $14.44 – $14.44 | 12 | 1 |
| Wauconda, IL | $10.08 | $10.08 – $10.08 | 12 | 1 |
| Hilton Head, SC | $24.80 | $24.80 – $24.80 | 12 | 1 |
| Sanborn, NY | $94.63 | $94.63 – $94.63 | 12 | 1 |
| Dallas, PA | $4,600 | $4,600 – $4,600 | 12 | 1 |
| Spencerport, NY | $134.57 | $134.57 – $134.57 | 12 | 1 |
| Fabens, TX | $0.00 | $0.00 – $0.00 | 12 | 1 |
| Kodak, TN | $105.70 | $105.70 – $105.70 | 12 | 1 |
| Ft Wainwright, AK | $11.30 | $11.30 – $11.30 | 12 | 1 |
| Balch Springs, TX | $0.00 | $0.00 – $0.00 | 12 | 1 |
| Carlin, NV | $5.41 | $5.41 – $5.41 | 12 | 1 |
| Warfield, KY | $12.50 | $12.50 – $12.50 | 12 | 1 |
| Springer, NM | $177.14 | $177.14 – $177.14 | 12 | 1 |
Cost Components
National averages for each billing code in this procedure category. Sorted by claim volume.
| Code | Description | Avg. Paid | Claims | Providers |
|---|---|---|---|---|
| H0020 | Alcohol and/or drug services | $20.02 | 312,323,784 | 3,904 |
| H0004 | Alcohol and/or drug services | $89.45 | 73,272,784 | 23,966 |
| H0038 | Self-help/peer svc per 15min | $102.60 | 30,385,812 | 7,670 |
| H0015 | Alcohol and/or drug services | $152.04 | 25,053,675 | 9,061 |
| H0005 | Alcohol and/or drug services | $53.46 | 23,222,742 | 9,936 |
| H2036 | A/d tx program, per diem | $258.14 | 18,209,988 | 1,399 |
| H0023 | Alcohol and/or drug outreach | $129.61 | 9,489,348 | 1,230 |
| H2035 | A/d tx program, per hour | $133.88 | 8,557,719 | 772 |
| H0006 | Alcohol and/or drug services | $58.37 | 8,299,938 | 8,185 |
| H0025 | Alcohol and/or drug preventi | $59.91 | 4,103,530 | 1,218 |
| H0010 | Alcohol and/or drug services | $422.31 | 3,875,371 | 395 |
| H0001 | Alcohol and/or drug assess | $82.04 | 3,265,107 | 5,031 |
| H0002 | Alcohol and/or drug screenin | $50.82 | 3,220,721 | 4,504 |
| H0049 | Alcohol/drug screening | $6.25 | 2,594,750 | 4,239 |
| H0022 | Alcohol and/or drug interven | $34.60 | 942,099 | 951 |
| T1012 | Alcohol/substance abuse skil | $61.60 | 820,776 | 236 |
| H0014 | Alcohol and/or drug services | $206.17 | 618,111 | 786 |
| H0012 | Alcohol and/or drug services | $266.77 | 587,849 | 172 |
| H0050 | Alcohol/drug service 15 min | $39.26 | 340,958 | 472 |
| H0007 | Alcohol and/or drug services | $261.94 | 101,784 | 110 |
| T1006 | Family/couple counseling | $172.57 | 38,563 | 50 |
These averages group common billing codes used when providers bill Medicaid for this procedure. Individual costs will vary.